Forms


Domestic Insurers are required to file the following documents by applicable dates:

  • Annual Financial Statement - March 1
  • Annual Audit and Examination Fee - March 1
  • Annual Fraud Unit Assessment Fee - June 1
  • 3 Quarterly Financial Statements - May 15, August 15, and November 15
  • Management Discussion and Analysis - April 1
  • Audited Financial Statements (CPA Report) - June 1
  • Form A – click HERE to electronically submit PDF copy of Form A and payment of $2,000 fee.
  • Form A Amendment – click HERE to electronically submit PDF copy of Amendment to Form A and payment of $1,000 fee.
  • Form A Exemption – click HERE to electronically submit PDF copy of an Application for Exemption from Form A and payment of $1,000 fee.
  • Disclaimer of Affiliation – click HERE to electronically submit PDF copy of a Disclaimer of Affiliation and payment of $1,000 fee.
  • Form B (including a $500 fee) - June 1
  • Form B Exemption (including a $100 fee) - June 1
  • Form C (including a $500 fee) - June 1
  • Form D (including a $500 fee)

Foreign Insurers are NO LONGER required to file Quarterly Financial statements or pay the Quarterly Audit and Examination Fee of $100.

All Sections listed on the following pages have instructions. Please download these instructions along with the required form.

  • As standard printed forms, these would be "front and back".
  • As PDF Downloads - please make sure you print all of the pages of the form.